New generation X-ray chest : Adding an “ echo vision ” to a blind PA view !

Reading X -ray chest can be as blind as a bat flying in the dark . It needs lots of Imagination . (Many times the blindness continues to cath lab as well  during structural interventions is a different story !) Yes ,its true  any one can recognise a cardiomegaly in X-ray  . . . but  Which chamber is responsible for cardiomegaly ? and quantifying each ones contribution to the increased CTR is the critical question.  We know the 4 chambers in the heart are arranged in a complex pre-specified  (Antero -superior and right to left orientation ) still , the CT ratio in X-RAY chest is based on the diameter formed by two chambers only ie right atrium and left ventricle. However, any of the 4  chamber enlargement can increase  CT ratio in pathological conditions. LV enlargement is the most common cause for cardiomegaly as it is the normally  border forming.(DCM, Aortic valve, HT diseases) RV can do it when it enlarger grossly forming the left heart border(COPD, Severe pulmonary hypertension of any cause) RA can enlarge to both pressure and volume overload.(CHF, with RVF) LA is least likely to be border forming as it is midline structure .Since It tends to enlarge posteriorly and superiorly it rarely enlarges sideways. Occasionally In severe mitral stenosis it can enlarge to the right and cross the right heart border causing the classical shadow in shadow. Since I have struggled with X ray orientation of heart chambers in my early days (Still i do sometimes!) Just thought ,...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardiac X ray Cardiology - Animations Cardiology - Clinical basics of chest x ray ct ratio how to measure ct ratio in ra lv rv la enlargment xray chest pa view xray chest pa vs ap view xray echo fusion Images Source Type: blogs